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By Jana Weis, Principal, Gill Compliance Solutions, LLC.

As consultants in the healthcare industry, we are asked all kinds of questions on a daily basis. Yet, if I were to add up the number of times clients ask about shared services, it would likely be on the top of the list. Shared services seem like an easy concept, two providers’ participation in the care of a patient, right? Well, almost right.

Let’s first take into consideration the CMS language surrounding shared services:

Every year we provide in-depth learning covering both the Inpatient Hospital PPD (IPPS) Final Rule and the Outpatient Prospective Payment System (OPPS) Final Rule. This year we covered the important issues in these Final Rules, as well as provided practical suggestions for how providers should respond to the changes from these new Rules, in two online webinars.

Understanding the climate of compliance has become paramount in running a successful practice. As the federal government focuses on finding “fraud and waste,” documentation expectations in both a hospital and private practice environments require a new set of rules.

We are pleased to announce our new and improved provider-specific MS-DRG Grouper and Calculator, powered by New Health Analytics. Demystify payment under the Inpatient Prospective Payment System, and understand and compare payment for different MS-DRGs, or for the same MS-DRG over time.

As we near the one-year mark to the updated ICD-10 deadline, we are continuing to provide ongoing educational resources to directly address the ongoing risks and challenges relating to the adoption of ICD-10 throughout your organization. Visit our online resource center to watch a replay of our four most recent ICD-10-related educational webinars:

Don’t forget that Alaska, Louisiana, Minnesota, Missouri, North Carolina and North Dakota now maintain separate Medicaid exclusion and sanction lists. And if you're not staying up to date with your sanction screening, your organization is at risk for severe penalties. Sanction Screening Services (S3™) delivers the next generation of self-managed and full service sanction and exclusion checking with up-to-date state and federal databases.

As the ICD-10-CM implementation date nears, it seems that the buzz has heightened and along with the buzz comes half-truths and misconceptions. A recent online article in Forbes’s magazine focused on coding. The article, “Doctors Lag Far Behind On New Medicare Diagnosis Codes,” implies that ICD-10-CM codes are Medicare codes. Because the United States uses ICD-9-CM (and eventually ICD-10-CM) in the billing process, we have ventured away from real reason we code: to have an efficient, consistent system of capturing data that supports healthcare decision making in our country. Do we ca

Managing hospital readmissions is one of the biggest challenges facing healthcare today. Many hospitals are experiencing a reduction in Medicare payments this fiscal year for having excess readmissions for acute myocardial infarction, heart failure, and pneumonia.